tbuckley/cabot-search huggingface dataset:
Frequency of Acute Kidney Injury and Association With Mortality Among Extremely Preterm Infants
Authors: Khyzer B. Aziz, Eric M. Schles, Kartikeya Makker, James L. Wynn
Journal: JAMA Network Open (2022)

Neonatal acute kidney injury (AKI) is common and associated with morbidity and mortality. The temporal relationship between AKI and critical illness, as well as the frequency of AKI definition components (urine output and serum creatinine [sCr] concentration change), are unknown in extremely low-birth-weight (ELBW) (<1000 g), extremely preterm (<29 weeks' completed gestational age [GA]) infants.To measure the frequency of AKI from birth to death or discharge with attention to the definition components as well as the temporal relationship of AKI to critical illness and death.A single-center, multiyear, retrospective cohort study was conducted at an academic level IV neonatal intensive care unit between January 1, 2012, and January 1, 2020. Participants included inborn ELBW and infants at 22 to 28 weeks' completed GA with confirmed congenital anomalies who survived 12 hours or more.Extremely preterm birth and ELBW.The primary outcome was AKI frequency. The timing, severity, and criteria for AKI were measured. The temporal relationship between AKI, organ dysfunction, and outcomes were quantified using odds ratios (ORs), logistic regression, and Shapley Additive Explanations. Acute kidney injury recognition, imaging, pediatric nephrology consultation, and follow-up were determined.A total of 436 infants (52% male; 44% Black) met the inclusion criteria (median BW, 725 g; median GA, 25.7 wk). Acute kidney injury was common in the first week of life (44%), primarily based on the change in the sCr concentration criterion (88%), and negatively associated with GA (OR, 0.69; 95% CI, 0.60-0.78), but positively associated with antecedent critical illness (OR, 1.17; 95% CI, 1.12-1.23), severe intraventricular hemorrhage (OR, 1.86; 95% CI, 1.12-3.08), late-onset sepsis (OR, 1.03; 95% CI, 1.02-1.03), and mortality (OR, 2.77; 95% CI, 1.63-4.72). Acute kidney injury had negligible clinical contribution to death within the model (Shapley Additive Explanation, <0.5% change to outcome) relative to antecedent patient-concentration organ dysfunction (6%-15% change). Among infants with severe AKI, recognition (32%), nephrology inpatient consultation (16%), and outpatient follow-up (9%) were not common.In this cohort study of ELBW infants, AKI was common in the first week of life, inversely associated with GA, and followed organ (primarily cardiovascular) dysfunction. Acute kidney injury considered as the primary pathway to mortality was rare, and amelioration of AKI to modify death was not well supported.
Q-Flux: A method to assess hepatic mitochondrial succinate dehydrogenase, methylmalonyl-CoA mutase, and glutaminase fluxes in vivo
Authors: Brandon T. Hubbard, Traci E. LaMoia, Leigh Goedeke, Rafael C. Gaspar, Katrine D. Galsgaard, Mario Kahn, Graeme F. Mason, Gerald I. Shulman
Journal: Cell Metabolism (2022)

The mammalian succinate dehydrogenase (SDH) complex has recently been shown as capable of operating bidirectionally. Here, we develop a method (Q-Flux) capable of measuring absolute rates of both forward (VSDH(F)) and reverse (VSDH(R)) flux through SDH in vivo while also deconvoluting the amount of glucose derived from four discreet carbon sources in the liver. In validation studies, a mitochondrial uncoupler increased net SDH flux by >100% in awake rodents but also increased SDH cycling. During hyperglucagonemia, attenuated pyruvate cycling enhances phosphoenolpyruvate carboxykinase efficiency to drive increased gluconeogenesis, which is complemented by increased glutaminase (GLS) flux, methylmalonyl-CoA mutase (MUT) flux, and glycerol conversion to glucose. During hyperinsulinemic-euglycemic clamp, both pyruvate carboxylase and GLS are suppressed, while VSDH(R) is increased. Unstimulated MUT is a minor anaplerotic reaction but is readily induced by small amounts of propionate, which elicits glucagon-like metabolic rewiring. Taken together, Q-Flux yields a comprehensive picture of hepatic mitochondrial metabolism and should be broadly useful to researchers.
Correcting Misinformation on Firearms Injuries
Authors: Philip J. Cook, Susan T. Parker
Journal: JAMA Network Open (2022)

Matthew Miller, MD, ScD, MPH; Deborah Azrael, PhD; Ravali Yenduri, MPH; Catherine Barber, MPA; Andrew Bowen, BS; Erin MacPhaul, MS; Stephen J. Mooney, PhD; Li Zhou, PhD; Eric Goralnick, MD; Ali Rowhani-Rahbar, MD, PhD
Effectiveness of Tuina Therapy Combined With Yijinjing Exercise in the Treatment of Nonspecific Chronic Neck Pain
Authors: Zi-ji Cheng, Shuai-pan Zhang, Yuan-jia Gu, Zi-ying Chen, Fang-fang Xie, Chong Guan, Min Fang, Fei Yao
Journal: JAMA Network Open (2022)

Importance Both tuina therapy and yijinjing exercise were beneficial to patients with nonspecific chronic neck pain, but the evidence for this combination is limited. Objective To investigate the effectiveness of tuina therapy combined with yijinjing exercise compared with tuina therapy alone for patients with nonspecific chronic neck pain. Design, Setting, and Participants A 12-week, open-label, analyst-blinded randomized clinical trial (8-week intervention plus 4-week observational follow-up) was conducted from September 7, 2020, to October 25, 2021. A total of 102 participants with nonspecific chronic neck pain were recruited, and data were analyzed from December 10, 2021, to March 26, 2022. Interventions Participants in the tuina group or tuina combined with yijinjing group received 3 sessions of tuina therapy per week for 8 weeks, for a total of 24 sessions. Participants in the tuina combined with yijinjing group practiced yijinjing 3 times a week for 8 weeks, including an instructor-guided exercise at the hospital and 2 self-practice exercises at home. Main Outcomes and Measures The primary outcome was change in visual analog scale (VAS) score from baseline to week 8. Secondary outcomes included Neck Disability Index scores, Self-rating Anxiety Scale scores, tissue hardness, and active range of motion. Results This randomized clinical trial recruited 102 patients (mean [SD] age, 36.5 [4.9] years; 69 [67.6%] female) who were randomized to 2 groups. All 102 patients (100%) completed all the outcome measurements. The mean difference in VAS scores from baseline at week 8 for the tuina combined with yijinjing group was −5.4 (95% CI, −5.8 to −5.1). At week 8, the difference in VAS score was −1.2 (95% CI, −1.6 to −0.8; P &amp;amp;lt; .001) between the tuina group and the tuina combined with yijinjing group. The effectiveness of tuina combined with yijinjing in treating nonspecific chronic neck pain remained at the 12-week follow-up. Conclusions and Relevance In this randomized clinical trial, for patients with nonspecific chronic neck pain, tuina combined with yijinjing was more effective than tuina therapy alone in terms of pain, functional recovery, and anxiety at week 8, and effectiveness remained at week 12. A combination of tuina and yijinjing should be considered in the management of nonspecific chronic neck pain. Trial Registration Chinese Clinical Trial Registry: ChiCTR2000036805
“Off-the-Shelf” CAR T-Cell Therapy Tested in Pediatric B-Cell Leukemia
Authors: Howard Larkin
Journal: JAMA (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Investigational RSV Vaccine Given During Pregnancy Protects Newborns
Authors: Howard Larkin
Journal: JAMA (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Assessment of the Accuracy of Firearm Injury Intent Coding at 3 US Hospitals
Authors: Matthew Miller, Deborah Azrael, Ravali Yenduri, Catherine Barber, Andrew Bowen, Erin MacPhaul, Stephen J. Mooney, Li Zhou, Eric Goralnick, Ali Rowhani-Rahbar
Journal: JAMA Network Open (2022)

Importance The absence of reliable hospital discharge data regarding the intent of firearm injuries (ie, whether caused by assault, accident, self-harm, legal intervention, or an act of unknown intent) has been characterized as a glaring gap in the US firearms data infrastructure. Objective To use incident-level information to assess the accuracy of intent coding in hospital data used for firearm injury surveillance. Design, Setting, and Participants This cross-sectional retrospective medical review study was conducted using case-level data from 3 level I US trauma centers (for 2008-2019) for patients presenting to the emergency department with an incident firearm injury of any severity. Exposures Classification of firearm injury intent. Main Outcomes and Measures Researchers reviewed electronic health records for all firearm injuries and compared intent adjudicated by team members (the gold standard) with International Classification of Diseases , Ninth and Tenth Revision, Clinical Modification ( ICD-9-CM and ICD-10-CM ) codes for firearm injury intent assigned by medical records coders (in discharge data) and by trauma registrars. Accuracy was assessed using intent-specific sensitivity and positive predictive value (PPV). Results Of the 1227 cases of firearm injury incidents seen during the ICD-10-CM study period (October 1, 2015, to December 31, 2019), the majority of patients (1090 [88.8%]) were male and 547 (44.6%) were White. The research team adjudicated 837 (68.2%) to be assaults. Of these assault incidents, 234 (28.0%) were ICD coded as unintentional injuries in hospital discharge data. These miscoded patient cases largely accounted for why discharge data had low sensitivity for assaults (66.3%) and low PPV for unintentional injuries (34.3%). Misclassification was substantial even for patient cases described explicitly as assaults in clinical notes (sensitivity of 74.3%), as well as in the ICD-9-CM study period (sensitivity of 77.0% for assaults and PPV of 38.0% for unintentional firearm injuries). By contrast, intent coded by trauma registrars differed minimally from researcher-adjudicated intent (eg, sensitivity for assault of 96.0% and PPV for unintentional firearm injury of 93.0%). Conclusions and Relevance The findings of this cross-sectional study underscore questions raised by prior work using aggregate count data regarding the accuracy of ICD -coded discharge data as a source of firearm injury intent. Based on our observations, researchers and policy makers should be aware that databases drawn from hospital discharge data (most notably, the Nationwide Emergency Department Sample) cannot be used to reliably count or characterize intent-specific firearm injuries.
Correction: DACH1 antagonizes CXCL8 to repress tumorigenesis of lung adenocarcinoma and improve prognosis
Authors: Qian Liu, Anping Li, Shengnan Yu, Shuang Qin, Na Han, Richard G. Pestell, Xinwei Han, Kongming Wu
Journal: Journal of Hematology & Oncology (2022)

The original article contained errors in Fig. 7. A549 vector in panel a should be labelled as vehicle and was duplicated with A549 vector in panel c.SKLU DACH1 in panel e should be labelled SKLU DACH1-vehicle, and was duplicated with SKLU CXCL-Ab in panel a.We repeated this experiment and presented right images with corresponding analysis.
Association of California Immigrants' Avoidance of Public Programs Due to Immigration Concerns With Delayed Access to Health Care
Authors: Joelle Wolstein, Susan H. Babey, Sean Tan, Riti Shimkhada, Ninez A. Ponce
Journal: JAMA Network Open (2022)

This cross-sectional study examines the association of avoidance of public programs among California immigrants with delayed access to health care services and prescriptions owing to concerns about how their interaction with these services may affect their immigration status.
Association Between Clinic-Reported Third Next Available Appointment and Patient-Reported Access to Primary Care
Authors: Nishwa Shah, Lidija Latifovic, Christopher Meaney, Rahim Moineddin, Mary Beth Derocher, Mohammad Alhaj, Tara Kiran
Journal: JAMA Network Open (2022)

This cross-sectional study examines the association of the third next available appointment with patient-reported measures of access in primary care settings.
Analysis of Human Leukocyte Antigen DR Alleles, Immune-Related Adverse Events, and Survival Associated With Immune Checkpoint Inhibitor Use Among Patients With Advanced Malignant Melanoma
Authors: Halis Kaan Akturk, Kasey L. Couts, Erin E. Baschal, Kagan E. Karakus, Robert J. Van Gulick, Jacqueline A. Turner, Laura Pyle, William A. Robinson, Aaron W. Michels
Journal: JAMA Network Open (2022)

Importance Treatment with immune checkpoint inhibitors (ICIs) has increased survival in patients with advanced malignant melanoma but can be associated with a wide range of immune-related adverse events (irAEs). The role of human leukocyte antigen (HLA)–DR alleles in conferring irAE risk has not been well studied. Objective To evaluate the association between irAEs and treatment response, survival, and the presence of HLA-DR alleles after ICI therapy in advanced melanoma. Design, Setting, and Participants This case-control study used the patient registry and biobanked samples from the tertiary referral University of Colorado Cancer Center. Specimens and clinical data were collected between January 1, 2010, and December 31, 2021. Patients with advanced (stage III unresectable and stage IV) melanoma who received ICI therapy (n = 132) were included in the analysis. Exposures Immune checkpoint inhibitors (anti–cytotoxic T-lymphocyte antigen 4, anti–programmed cell death protein 1 or its ligand, or the combination) for the treatment of advanced melanoma. Main Outcomes and Measures The association between irAEs and response to therapy, survival, and HLA-DR alleles. Results Among the cohort of 132 patients with advanced melanoma (mean [SD] age, 63.4 [7.2] years; 85 men [64%] and 47 women [36%]) treated with ICIs, 73 patients had at least 1 irAE and 59 did not have an irAE. Compared with patients without an irAE, patients with an irAE had higher treatment response rates (50 of 72 [69%] vs 28 of 57 [49%]; P = .02) and increased survival (median, 4.8 [IQR, 0.2-9.6] vs 3.2 [IQR, 0.1-9.2] years; P = .02). Specific HLA-DR alleles were associated with the type of irAE that developed: 7 of 10 patients (70%) who developed type 1 diabetes had DR4; 6 of 12 (50%) who developed hypothyroidism had DR8; 5 of 8 (63%) who developed hypophysitis had DR15; 3 of 5 (60%) who developed pneumonitis had DR1; and 8 of 15 (53%) who developed hepatitis had DR4. Conclusions and Relevance These findings suggest that IrAEs are associated with treatment response rates and increased survival after ICI therapy for advanced melanoma. Because distinct HLA-DR alleles are associated with given adverse events, HLA genotyping before ICI therapy may aid in identifying risk for specific irAEs that could develop with such treatment.
SP140 inhibits STAT1 signaling, induces IFN-γ in tumor-associated macrophages, and is a predictive biomarker of immunotherapy response
Authors: Kranthi Kiran Kishore Tanagala, Joshua Morin-Baxter, Richard Carvajal, Maryum Cheema, Sunil Dubey, Hiroshi Nakagawa, Angela Yoon, Yi-Shing L Cheng, Alison Taylor, Jeffrey Nickerson, Akiva Mintz, Fatemeh Momen-Heravi
Journal: Journal for ImmunoTherapy of Cancer (2022)

Background Understanding the role and potential therapeutic targeting of tumor-associated macrophages (TAMs) is crucial to developing new biomarkers and therapeutic strategies for cancer immunotherapies. The epigenetic reader SP140 has emerged as a master regulator of macrophage transcriptional programs; however, its role in the signaling of TAMs and response to immunotherapy has not been investigated. Methods We evaluated the correlation between SP140 expression in head and neck squamous cell carcinoma (HNSCC) TAMs and clinical outcomes. We also used complementary bioinformatics and experimental approaches to study the association of SP140 expression with tumor mutation burden, patient survival, immunogenic signature of tumors, and signaling of TAMs. SP140 overexpression or knockdown was implemented to identify the role of SP140 in downstream signaling and production of inflammatory cytokine and chemokines. Chromatin immunoprecipitation and analysis of assay of transposase accessible chromatin sequencing data were used to demonstrate the direct binding of SP140 on the promoters of STAT1. Finally, correlation of SP140 with immune cell infiltrates and response to immune-checkpoint blockade in independent cohorts of HNSCC, metastatic melanoma, and melanoma was assessed. Results We found that SP140 is highly expressed in TAMs across many cancer types, including HNSCCs. Interestingly, higher expression of SP140 in the tumors was associated with higher tumor mutation burden, improved survival, and a favorable response to immunotherapy. Tumors with high SP140 expression showed enrichment of inflammatory response and interferon-gamma (IFN-γ) pathways in both pan-cancer analysis and HNSCC-specific analysis. Mechanistically, SP140 negatively regulates transcription and phosphorylation of STAT1 and induces IFN-γ signaling. Activating SP140 in macrophages and TAMs induced the proinflammatory macrophage phenotype, increased the antitumor activity of macrophages, and increased the production of IFN-γ and antitumor cytokines and chemokines including interleukin-12 and CXCL10. SP140 expression provided higher sensitivity and specificity to predict antiprogrammed cell death protein 1 immunotherapy response compared with programmed death-ligand 1 in HNSCCs and lung cancer. In metastatic melanoma, higher levels of SP140 were associated with a durable response to immunotherapy, higher immune score estimates, high infiltrations of CD8 + T cells, and inflammatory TAMs. Conclusions Our findings suggest that SP140 could serve as both a therapeutic target and a biomarker to identify immunotherapy responders.
Evaluation of Comprehensive COVID-19 Testing Program Outcomes in a US Dental Clinical Care Academic Setting
Authors: Sung Eun Choi, Corneliu Sima, Laura Pesquera Colom, Giang T. Nguyen, William V. Giannobile
Journal: JAMA Network Open (2022)

Although many academic institutions have implemented infection control and prevention protocols, including regular asymptomatic self-testing, in response to the COVID-19 pandemic, the outcomes of mandatory surveillance testing programs at academic dental institutions that offer direct patient-facing clinical care has not yet been reported.To report the findings of a comprehensive surveillance COVID-19 testing program at an academic dental institution by assessing SARS-CoV-2 positivity rates and the potential association of test positivity with individual-level characteristics such as age, sex, and role.A retrospective cohort study was conducted using SARS-CoV-2 self-testing data from a mandatory surveillance program at the Harvard School of Dental Medicine. Test results obtained between August 24, 2020, and February 28, 2022, from students, faculty, and staff members were analyzed. Testing cadence varied from 1 to 3 times per week depending on risk status. The association of individual characteristics with test positivity was evaluated with univariate analyses and a bayesian multilevel logistic regression model.Age by decade, sex, and role or position category (staff members, faculty, and students stratified by their involvement in clinical care activities), testing cadence, and testing date.Positive results from SARS-CoV-2 real-time reverse transcription-polymerase chain reaction self-tests were assessed.Of the 390 study participants, 210 (53.8%) were women. Participants were grouped by age as follows: 20 to 29 years (190 [48.7%]), 30 to 39 years (88 [22.6%]), 40 to 49 years (44 [11.3%]), 50 to 59 years (42 [10.8%]), and 60 years or older (26 [6.7%]). Test results demonstrated an overall 0.27% positivity rate (61 test-positive cases), with a peak weekly positivity rate of 5.12% in the first week of January 2022. The mean (SD) test positivity rate among those involved in clinical activities was 0.25% (0.04) compared with 0.36% (0.09) among nonclinical participants. When adjusting for all considered covariates, test positivity was significantly associated with testing frequency (3 times vs 1 time per week: odds ratio [OR], 1.51 [95% credible interval (CrI), 1.07-3.69]) and timing of the test (after vs during the Alpha wave: OR, 0.33 [95% CrI, 0.11-0.88]; and Omicron vs Alpha: OR, 11.59 [95% CrI, 6.49-22.21]) but not with individual characteristics (age, sex, and role).These findings suggest that implementing an adaptive testing cadence based on the risk status of individuals may be effective in reducing the risk of SARS-CoV-2 infection within an institution. In this study, involvement in clinical activities did not pose additional risk of SARS-CoV-2 infection compared with other in-person activities in the presence of these control measures.